401k Plan data: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS plan

STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 401k Plan overview

Plan Name	STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS
Plan identification number	506

STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

STAFF MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: STAFF MANAGEMENT, INC.

Employer identification number (EIN): 363243445

NAIC Classification: 561300

Additional information about STAFF MANAGEMENT, INC.

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2008-05-14

Company Identification Number: 20081448592

Legal Registered Office Address: 2736 FERRIN RD

LAS VEGAS
United States of America (USA)
89117

More information about STAFF MANAGEMENT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2024-01-01 JOHN MORRISSEY
506 2023-01-01
506 2023-01-01 JOHN MORRISSEY
506 2022-01-01
506 2022-01-01 JOHN MORRISSEY
506 2021-01-01
506 2021-01-01 JOHN MORRISSEY
506 2020-01-01
506 2019-01-01
506 2018-01-01
506 2017-01-01 JOHN MORRISSEY JOHN MORRISSEY 2018-09-11
506 2016-01-01 JOHN MORRISSEY JOHN MORRISSEY 2017-08-11
506 2015-01-01 JOHN MORRISSEY JOHN MORRISSEY 2016-07-26
506 2014-01-01 JEFFREY HUBER JEFFREY HUBER 2015-08-26
506 2013-01-01 JEFFREY HUBER JEFFREY HUBER 2014-07-17
506 2012-01-01 JEFFREY HUBER JEFFREY HUBER 2013-07-30
506 2011-01-01 JEFFREY HUBER JEFFREY HUBER 2012-07-16
506 2009-01-01 JEFFREY HUBER JEFFREY HUBER 2010-07-19

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
506	2024-01-01	JOHN MORRISSEY
506	2023-01-01
506	2023-01-01	JOHN MORRISSEY
506	2022-01-01
506	2022-01-01	JOHN MORRISSEY
506	2021-01-01
506	2021-01-01	JOHN MORRISSEY
506	2020-01-01
506	2019-01-01
506	2018-01-01
506	2017-01-01	JOHN MORRISSEY	JOHN MORRISSEY	2018-09-11
506	2016-01-01	JOHN MORRISSEY	JOHN MORRISSEY	2017-08-11
506	2015-01-01	JOHN MORRISSEY	JOHN MORRISSEY	2016-07-26
506	2014-01-01	JEFFREY HUBER	JEFFREY HUBER	2015-08-26
506	2013-01-01	JEFFREY HUBER	JEFFREY HUBER	2014-07-17
506	2012-01-01	JEFFREY HUBER	JEFFREY HUBER	2013-07-30
506	2011-01-01	JEFFREY HUBER	JEFFREY HUBER	2012-07-16
506	2009-01-01	JEFFREY HUBER	JEFFREY HUBER	2010-07-19

Plan Statistics for STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS

401k plan membership statisitcs for STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS

Measure Date Value
2023: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2023 401k membership
Total participants, beginning-of-year 2023-01-01 381
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 363
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 363
2022: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2022 401k membership
Total participants, beginning-of-year 2022-01-01 358
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 381
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 381
2021: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2021 401k membership
Total participants, beginning-of-year 2021-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 358
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 358
2020: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2020 401k membership
Total participants, beginning-of-year 2020-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 233
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 233
2019: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2019 401k membership
Total participants, beginning-of-year 2019-01-01 357
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 233
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 233
2018: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2018 401k membership
Total participants, beginning-of-year 2018-01-01 371
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 357
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 357
2017: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2017 401k membership
Total participants, beginning-of-year 2017-01-01 451
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 371
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 371
2016: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2016 401k membership
Total participants, beginning-of-year 2016-01-01 451
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
2015: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2015 401k membership
Total participants, beginning-of-year 2015-01-01 462
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 451
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 451
2014: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2014 401k membership
Total participants, beginning-of-year 2014-01-01 405
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 462
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 462
2013: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2013 401k membership
Total participants, beginning-of-year 2013-01-01 503
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 405
Total of all active and inactive participants 2013-01-01 405
2012: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2012 401k membership
Total participants, beginning-of-year 2012-01-01 435
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 503
Total of all active and inactive participants 2012-01-01 503
2011: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2011 401k membership
Total participants, beginning-of-year 2011-01-01 423
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 435
Total of all active and inactive participants 2011-01-01 435
2009: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2009 401k membership
Total participants, beginning-of-year 2009-01-01 599
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 452
Total of all active and inactive participants 2009-01-01 452

Measure	Date	Value
2023: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2023 401k membership
Total participants, beginning-of-year	2023-01-01	381
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	363
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	363
2022: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2022 401k membership
Total participants, beginning-of-year	2022-01-01	358
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	381
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	381
2021: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2021 401k membership
Total participants, beginning-of-year	2021-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	358
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	358
2020: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2020 401k membership
Total participants, beginning-of-year	2020-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	233
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	233
2019: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2019 401k membership
Total participants, beginning-of-year	2019-01-01	357
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	233
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	233
2018: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2018 401k membership
Total participants, beginning-of-year	2018-01-01	371
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	357
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	357
2017: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2017 401k membership
Total participants, beginning-of-year	2017-01-01	451
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	371
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	371
2016: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2016 401k membership
Total participants, beginning-of-year	2016-01-01	451
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
2015: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2015 401k membership
Total participants, beginning-of-year	2015-01-01	462
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	451
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	451
2014: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2014 401k membership
Total participants, beginning-of-year	2014-01-01	405
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	462
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	462
2013: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2013 401k membership
Total participants, beginning-of-year	2013-01-01	503
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	405
Total of all active and inactive participants	2013-01-01	405
2012: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2012 401k membership
Total participants, beginning-of-year	2012-01-01	435
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	503
Total of all active and inactive participants	2012-01-01	503
2011: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2011 401k membership
Total participants, beginning-of-year	2011-01-01	423
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	435
Total of all active and inactive participants	2011-01-01	435
2009: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2009 401k membership
Total participants, beginning-of-year	2009-01-01	599
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	452
Total of all active and inactive participants	2009-01-01	452

Form 5500 Responses for STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS

2023: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: STAFF MANAGEMENT INC LIFE INSURANCE A D & D INSURANCE, & DEPENDENT LIFE INS 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

393276

Policy instance

Insurance contract or identification number	393276
Number of Individuals Covered	26
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Welfare Benefit Premiums Paid to Carrier	USD $9,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

Insurance contract or identification number	218997
Number of Individuals Covered	222
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $5,365
Total amount of fees paid to insurance company	USD $502
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $39,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

1329560001

Policy instance

Insurance contract or identification number	1329560001
Number of Individuals Covered	6
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

1329560800

Policy instance

Insurance contract or identification number	1329560800
Number of Individuals Covered	1
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

Insurance contract or identification number	218998
Number of Individuals Covered	95
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $7,110
Total amount of fees paid to insurance company	USD $593
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $47,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

218999

Policy instance

Insurance contract or identification number	218999
Number of Individuals Covered	8
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $421
Total amount of fees paid to insurance company	USD $35
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

219000

Policy instance

Insurance contract or identification number	219000
Number of Individuals Covered	5
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $224
Total amount of fees paid to insurance company	USD $28
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

1329560001

Policy instance

Insurance contract or identification number	1329560001
Number of Individuals Covered	6
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,845
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

1329560800

Policy instance

Insurance contract or identification number	1329560800
Number of Individuals Covered	1
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $327
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

Insurance contract or identification number	218998
Number of Individuals Covered	79
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $6,805
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $41,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

218999

Policy instance

Insurance contract or identification number	218999
Number of Individuals Covered	8
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $418
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

219000

Policy instance

Insurance contract or identification number	219000
Number of Individuals Covered	5
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $242
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

393276

Policy instance

Insurance contract or identification number	393276
Number of Individuals Covered	26
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,336
Welfare Benefit Premiums Paid to Carrier	USD $9,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

Insurance contract or identification number	218997
Number of Individuals Covered	231
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,996
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $41,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

219000

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

218999

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

1329560800

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

1329560001

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

393276

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

218999

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

219000

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

393276

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

218999

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

219000

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

219000

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

218999

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218998

Policy instance

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

218997

Policy instance

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

036-4956-00

Policy instance

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

036-4956-00

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Company Name:	STAFF MANAGEMENT, INC.
Employer identification number (EIN):	363243445
NAIC Classification:	561300

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2008-05-14
Company Identification Number:	20081448592
Legal Registered Office Address:	2736 FERRIN RD LAS VEGAS United States of America (USA) 89117